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A couple of weeks ago on Real Time, Jack Kingston told us about all the people who come into the United States seeking medical treatment from "the best healthcare system in the world." Not only is this oft-parroted argument out of touch, it's actually out of date: For several years, the number of people leaving the United States for medical care has outnumbered people coming in, and that gap is growing.

According to a study by the Deloitte Center for Health Solutions, it breaks down like this: Inbound medical tourism is growing, but slowly. Somewhere between 60,000 and 85,000 came here to seek treatment in 2008, and the number is projected to grow to slightly over half a million by 2017. But outbound medical tourism, Americans going abroad, was 750,000 in 2007, a big uptick from the year before. And the number ballooned to 1.3 million Americans in 2008.

It's still going up, by all reports, but the trend line was clear long before Obamacare or even President Obama: Our healthcare system wasn't working, and it was getting worse. Just as they like to ignore the financial shitstorm Obama inherited, Republicans choose to forget that our medical system was also in crisis when we elected Obama.

One reason for Americans getting treated overseas, obviously, is cost. Services abroad are 80 percent cheaper, on average. But they're not just looking for healthcare on the cheap. According to a McKinsey Company report, 40% of medical tourists are seeking better technology, and 32% are looking for better care. Also, despite the dire warnings about future waiting lists and rationing, it's already here. 15% of outgoing medical tourists are doing it because of shorter waiting periods for procedures.

Don't try telling this to Republicans, though -- they still need to believe in the America that draws people to its awesome healthcare, just like they can't let go of the idea that Mexicans are still pouring over the border. Because once they start admitting that the world is just not that into us anymore, they'll have to start examining what we actually have.